SITUATION IN HONG KONG: COVID-19 1
The Situation in Hong Kong during the COVID-19 Pandemic
Abstract
This paper briefly discussed the reactions and responses towards the COVID-19 pandemic in
Hong Kong, amidst major political strife. The traumatic memories from SARS in 2003 as well as the displease and distrust towards the Hong Kong government have aggravated mental health distress during the pandemic while this adversity has also increased community support. This article discusses the specific challenges of the COVID-19 pandemic in Hong
Kong and proposes lessons learned during the pandemic, including strategies for mental health professionals and the community to reduce psychological distress.
SITUATION IN HONG KONG: COVID-19 2
The Situation in Hong Kong during the COVID-19 Pandemic
Hong Kong has been responding to the COVID-19 pandemic since early January
(Information Services Department, HKSAR, 2020). As of 19 April 2020, a total of 1,024
COVID-19 cases have been confirmed in Hong Kong, including four deaths (Centre for
Health Protection [CHP, HKSAR], 2020a). Handwashing and use of masks are recommended preventive measures against the pandemic (CHP, HKSAR, 2020b). Non-Hong Kong residents were denied entry from overseas, and people entering from mainland China, Macao, and
Taiwan were forcibly quarantined (HKSAR, 2020a). Classes have been suspended, and regulations to maintain social distancing have been imposed with legal consequences on group gatherings and businesses (HKSAR, 2020b). However, with a lower number of locally transmitted cases, people began to ignore social distancing rules and resumed shopping and gathering together (Sun, Tsang, Wong & Zhang, 2020).
The Mental Health of Hong Kongers under the Pandemic
In a recent internet survey concerning mental health among the 762 people living in
Hong Kong during the COVID-19 pandemic, 40.6% reported symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD; Lau & Ng, 2020). However, such results might not accurately reflect the extent of the pandemic’s effect on the peoples’ mental health in Hong Kong. Starting in June 2019, people in Hong Kong experienced one of the most significant cases of social unrest in local history, with escalating levels of violence by SITUATION IN HONG KONG: COVID-19 3 both the protestors and authorities. Ni et al. (2020) reported substantial mental health burdens during the social unrest in Hong Kong, with 11.2% and 12.8% of the participants reporting probable depression and PTSD, respectively. While the social unrest appeared to recede as a result of the pandemic (Wong, 2020), the impacts on mental health nevertheless continued, exacerbated by the outbreak of COVID-19. A survey on the performance of the Hong Kong government in response to the pandemic revealed distrust towards authorities, with 70% of respondents crediting the community instead of the government for the successes achieved against COVID-19 (Cheung & Wong, 2020).
From our clinical observations, the precedent of social movements, the COVID-19 outbreak, and distrust of the government have created lots of tension in the society. The stay- at-home policies have provided more opportunities for family conflicts related to political views and hygiene issues. Particularly, many clients have complained of boredom and irritation at home, have reported distress from reduced income and the loss of jobs, and anger towards the government’s ineffective policies for managing the virus outbreak. As a result, some individuals feel hopeless about the future of Hong Kong and have a strong intention to emigrate. On the other hand, a local survey also indicated positive discoveries in the current pandemic in Hong Kong (Lau & Ng, 2020). In particular, more than 60% of the survey respondents reported enhanced health awareness of self and others, deeper reflection on personal values, and greater concern and regard to family and friends. SITUATION IN HONG KONG: COVID-19 4
Hong Kongers’ Response to the Pandemic
The response of the people in Hong Kong towards the current pandemic might have been a residual reaction from the trauma of SARS in 2003. The SARS and COVID-19 pandemics are similar in many respects and both outbreaks were preceded by heightened political controversy (Sala, 2020). People in Hong Kong did not wait for the official guidelines, and began handwashing and wearing facemasks in public (Walsh, 2020), and stockpiling food and supplies. As people in Hong Kong have generally been dissatisfied with the government's performance (Cheng, 2020; Cheung & Wong, 2020), many individuals became active and creative and helped each other, e.g., by distributing relief supplies and protective equipment to those in need (Lau & Ng, 2020).
Helpful and Less Helpful Responses
A survey was conducted by The Chinese University of Hong Kong to investigate the risk perception and psycho-behavioral responses to the outbreak of COVID-19. The results showed that the respondents' average anxiety level was above the clinical threshold (8.82;
The Chinese University of Hong Kong, 2020), suggesting that many respondents met a clinically significant level of anxiety. However, the anti-epidemic funds from the government are not helping to address the need for psychological intervention. Private mental healthcare organizations do not benefit from this scheme (Hung, 2020). Due to the reduction of income,
34.8% of these organizations are planning to terminate their businesses in a month (Cheung, SITUATION IN HONG KONG: COVID-19 5
2020). In view of the drastic shutdown of private organziations, service users have to seek help from public services. Consequently, the burden on mental health services in public hospitals might increase, implying that government intervention is less than helpful.
Technology has been a beneficial element in this period. Online platforms provide helpful tools for connecting people who need to maintain social distance (Zhou et al., 2020).
They allow mental health practitioners to offer telecounseling, which maintains some level of accessibility of services to clients.
Healthcare in Hong Kong
The Hospital Authority has organized special arrangements in the public hospitals and clinics. This includes supporting people in 14-day compulsory home quarantine in rescheduling appointments, refilling medication, and laboratory surveillance (Hospital
Authority, 2020). From the community perspective, people in Hongkong have a high awareness and alertness to COVID-19, so most people have the practice of protecting their health by wearing masks, washing their hands, and practicing other safety measures. Also, people need to measure their temperatures before entering public facilities (Sataline, 2020).
Recommendations derived from the Lessons Learned
Based on our experiences meeting recent challenges, we make several recommendations for mental health professionals around the globe to support their psychological services during the pandemic: SITUATION IN HONG KONG: COVID-19 6
At the governmental level, non-government organizations and individual mental
health practitioners independently provide support in Hong Kong. We suggest
advocacy of the government sector initiating a leadership role to integrate public
hospitals, agencies, and private service providers, by sharing psychological resources,
jointly organizing online workshops on coping with the mental health burden during
COVID-19, sharing linguistic and cultural competence to reach different clients, and
developing a system of client referral for telecounseling to enhance accessibility for
different populations.
At a community level, we encourage mental health agencies and professionals to
explore the use of telecounseling. We have learned that human contact is a genuine
and crucial protective factor for reducing emotional distress, and that
telecommunication has been effective in Hong Kong to allow for human contact.
Moreover, health and mental health online programs and campaigns are valuable. For
example, agencies have organized free online Zentangle classes (Tsz Shan Monastery,
2020), open discussions on mental health wellbeing during virus by professionals
(LoveHK LoveU, 2020), Do It Yourself (DIY) instructions of making facemasks and
sanitizers (HK MASK, 2020), and self-help Cognitive Behavioural Therapy (CBT)
courses (Institute of Cognitive Therapy, 2020), which can serve as references for other
countries. SITUATION IN HONG KONG: COVID-19 7
For everyone, including professionals, self-care during this difficult time is crucial. In
particular, it is important to acknowledge and accept the fear and stress, and to
explore interesting activities at home, maintaining social connections through media,
and practicing self-care skills such as meditation and yoga. SITUATION IN HONG KONG: COVID-19 8
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